Trauma and coagulopathy: a new paradigm to consider.

I njury, intentional and unintentional, is one of the main causes of death for adult Americans. Further, from 1999 to 2003, injury was the main cause of premature mortality (measured as potential years of life lost), ahead of malignancy and heart disease, for Americans who died before their 65th birthday. Injuries that cause massive hemorrhage are often associated with the highest mortality rates. More than 50% of patients who present with massive hemorrhage die, and for those who die within hours of the injury event, it is often the most common cause of death.